Individual
BRADLEY J COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 793-2104
(401) 793-4047
Mailing address
117 ELLENFIELD ST, PROVIDENCE, RI 02905-4513
(401) 444-4318
(401) 444-6573
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD12142
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31603-7
BCBS RI
RI
01
—
413540
BLUECHIP
RI
05
—
7058655
—
RI
01
—
AA68866
HPHC
RI
01
—
MD12142
MEDICAL LICENSE
RI
Enumeration date
07/12/2006
Last updated
04/10/2015
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